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General NPI Number Information
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NPI Number | 1861750010
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Entity Type | Organization
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Legal Business Name | ROME MEDICAL PRACTICE
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 267 HILL RD SUITE 100
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City | ROME
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State | NY
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Zip | 13441-4203
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Country | US
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Telephone | 315-356-7380
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Fax | 315-356-7386
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Provider Business Mailing Address
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Address Line | 245 HILL RD
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City | ROME
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State | NY
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Zip | 13441-4203
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Country | US
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Telephone | 315-337-0429
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Fax | 315-356-0583
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Authorized Official
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Title or Position | PRESIDENT
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Name | SALTZGABER LEE
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Credential | MD
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Telephone | 315-338-7232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 003788-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 003788-1
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License Number State | NY
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